Family members and even primary healthcare providers often mistake an older adult’s symptoms of depression as just a natural reaction to illness or an unavoidable part of the aging process. Older adults themselves often share this belief and suffer unnecessarily because they don’t understand that they could feel better with appropriate treatment.

Statistics on Mental Health and Seniors

Recent data indicate that an estimated 20.4 percent of adults aged 65 and older met criteria for a mental disorder. (Karel, Gatz & Smyer, 2012). The CDC’s 2013 report on The State of Aging and Health in America identified “addressing mental distress among older adults” as one of its primary Calls To Action needed to improve the health and well-being of older adults. The CDC estimates: About 25% of adults aged 65 years or older have some type of mental health problem, such as a mood disorder not associated with normal aging. Mental distress is a problem by itself, and it has been associated with unhealthy behaviors than can interfere with self-management and inhibit recovery from an illness.

How Can we Help Change these Statistics?

Talking to seniors about their mental health can be challenging. Family members, caregivers, and even many medical professionals are not trained to assess mental disorders. Conversations can be awkward. Seniors are often reluctant to talk about their symptoms.

The most common mental disorder among older adults is depression. Depression, once diagnosed, often responds quickly to treatment. Most older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. If left untreated, however, depression may result in the onset of physical, cognitive, functional, and social impairment, as well as decreased quality of life.

If you suspect an older adult has depression, there is an easy, direct way to talk with them about their symptoms. The Geriatric Depression Scale (GDS) is a reliable 15-question assessment that anyone can use. Ask the senior to answer the following questions:

Geriatric Depression Scale: Short Form
Choose the best answer for how you have felt over the past week:
1. Are you basically satisfied with your life? YES / NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES / NO
6. Are you afraid that something bad is going to happen to you? YES / NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO
10. Do you feel you have more problems with memory than most? YES / NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO
13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES / NO

Answers in bold indicate depression. Score 1 point for each bolded answer.
A score > 5 points is suggestive of depression.
A score ≥ 10 points is almost always indicative of depression.

Source: http://www.stanford.edu/~yesavage/GDS.html
This scale is in the public domain.

Any score greater than 5 warrants a follow-up assessment by a medical professional. If your senior scores higher than 5, help them schedule an appointment to discuss the results and form a treatment plan with a healthcare provider.

If you or someone you care about is in crisis, please seek help immediately using one of the following methods:

U.S. Department of Health and Human Services, National
Institutes of Health, National Institute of Mental Health. (2015).Depression (NIH Publication No. 15-3561). Bethesda, MD: U.S.
Government Printing Office.

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One in 10 Americans are suffering from Depression at any given time. Are you worried someone you know may be more than just sad? It is often hard to know the difference between Clinical Depression and sadness. In this 4-minute Ted-Ed video, Helen M. Farrell examines the symptoms and treatments of depression, and gives some tips for how you might help a friend who is suffering.

A surprising statistic from the video:An individual waits and average of 10 years to seek help for depression.

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Researchers at Johns Hopkins showed CBT for pain management with patients with knee osteoarthritis (KOA) significantly improved their symptoms. Patients in the study reported significantly lower levels of pain after CBT sessions. Additionally, patients with KOA in the study reported improved quality of sleep. The new double-blind, randomized placebo-controlled clinical trial findings were published online January 26 in Arthritis and Rheumatology. Jennifer Garcia summarizes the results of the study in the February 25, 2015, edition of OrthoSpineNew.

The concepts from Cognitive Behavioral Therapy (CBT) can be especially helpful when trying to lose weight. In this week’s ReadersINC blog post, Anthony Healy, a personal trainer at Vivacia, outlines ideas on motivation for weight loss. Each of these ideas is an example of techniques learned during Cognitive Behavioral Therapy.

Here are Anthony’s top tips on how to motivate yourself to lose weight:

1. Decide why you want to lose weight

Is it to look good in a bikini, to feel better about yourself or another reason?

2. Set goals

‘Lose weight’ is too vague. You need a clear and achievable goal, such as ‘lose 10lb in 10 weeks’. Write down how you’re going to achieve this, such as ‘run three times a week’ or ‘go to the gym every Monday, Wednesday and Friday’ and STICK TO IT.

2. Create visual goals

Visual cues are a great motivator. If you want to look good on the beach in a size 10 bikini then buy that bikini (or dress for special occasion/favorite pair of jeans) and hang it outside your wardrobe.

3. Write a morning mantra

Write and then read a motivational mantra every day. Make the goal seem like something that has already having been achieved,

E.g. “I have successfully lost 10lbs, and I am about to board the plane for Spain at Heathrow airport. I can’t wait to get to the beach in my yellow bikini….”

By doing so you get the good feelings associated with the goal ahead of time.

4. Kick the bad habits

Long-term transformations take time.

To get quick results and keep the weight off you need to kick bad habits.

In the beginning you need to go cold turkey. For many people the enemy is booze, processed food and/or sugar in all its forms – most obviously, chocolate and sweets.

Giving these up for at least 6-12 weeks “breaks the back” of the usual suspects, forms some good eating habits, and brings about those quick results – which will keep you motivated and “hungry” for more success.

5. Think positive

With sufficient motivation anything is achievable, and those obstacles can now be overcome.

CBT for Anger is one of the most effective ways to treat uncontrolled anger problems. Anger can be managed using a method from Cognitive Behavioral Therapy (CBT) called Cognitive Reframing.

In the following article published on PsychCentral.com, Dr. Hartwell-Walker outlines 7 common assumptions that can be reframed to reduce anger.

7 Mistaken Assumptions Angry People Make By Marie Hartwell-Walker, Ed.D.

“I guess I have an anger problem. I lose my temper pretty quick. But it’s not like my wife doesn’t do things to make me mad.”

Richard has reluctantly come to treatment because his wife took out a restraining order after their last fight. He admits he lost control. He acknowledges that maybe he said things he shouldn’t have. But he also thinks she shouldn’t have done or said what she did. “I can’t help getting mad when she jerks my chain. I can’t let her get away with that!” he says.

Raging, shouting, name-calling, throwing things and threatening harm is all a big bluff. It’s the human equivalent of animal behavior. From the puffer fish that puffs itself up to twice its size to look more intimidating to the lion on the veldt who shakes his mane and roars, creatures who feel threatened posture and threaten in order to protect themselves and their turf. The display often is enough to get the predator or interloper to back off. If not, the fight — or flight — is on.

People who rage are the same. Feeling a threat, they posture. They throw away all mature controls and rant and rage like an out-of-control 2-year-old. It’s impressive. It’s scary. It gets folks around them to walk around on eggshells. Others often let them “win” just to get away.

But are they happy? Usually not. When I talk to the Richards of the world, they usually just want things to go right. They want respect. They want their kids and their partners to give them the authority they think they deserve. Sadly, their tactics backfire. Not knowing what might set him off, kids, partners, coworkers and friends distance and leave him more and more alone.

Helping someone like Richard with “anger management” requires more than helping him learn how to express his angry feelings appropriately. Giving him practical skills alone assumes more control than he can probably hold on to. To be able to integrate those skills into his self-image, he needs to reconsider some of his basic assumptions about life and his place in it.

7 Mistaken Assumptions Angry People Often Make

They can’t help it. Angry people have lots of excuses. Women will blame their PMS. Both sexes will blame their stress, their exhaustion, or their worries. Never mind that other people who have PMS or who are stressed, tired, or worried don’t pop off at the world. Angry people don’t yet understand that they are actually giving themselves permission to rant. In that sense, they are very much in control.The only way to express anger is to explode. People who rage believe that anger is like the buildup of steam in an overheated steam engine. They think they need to blow off the steam in order to be OK. In fact, raging tends only to produce more of the same.Frustration is intolerable. Angry people can’t sit with frustration, anxiety or fear. To them, such feelings are a signal that they are being challenged. When life doesn’t go their way, when someone doesn’t see things as they do, when their best-laid plans get interrupted or they make a mistake, they simply can’t tolerate it. To them, it’s better to blow than to be left with those feelings. They don’t get it that frustration is a normal part of everyone’s life and that it is often the source of creativity and inspiration.It’s more important to win than to be right. Chronically angry people often have the idea that their status is at stake when there is conflict. When questioned, they take it overly personally. If they are losing an argument, they experience a loss of self-esteem. At that moment, they need to assert their authority, even if they are wrong. When it is certain that they are wrong, they will find a way to prove that the other person is more wrong. For mature people, self-esteem is grounded in being able to put ego aside in order to find the best solution.“Respect” means that people do things their way. When another driver tailgates, when a partner refuses to go along with a plan, when a kid doesn’t jump when told to do something, they feel disrespected. To them, disrespect is intolerable. Making a lot of noise and threatening is their way of reasserting their right to “respect” by others. Sadly, when the basis of “respect” is fear, it takes a toll on love and caring.The way to make things right is to fight. Some angry people have learned at the feet of a master. Having grown up with parents who fight, it is their “normal.” They haven’t a clue how to negotiate differences or manage conflict except by escalating. Then they become very much like the parent they loathed and feared when they were kids.Other people should understand that they didn’t mean what they did or said when they were angry. Angry people feel that anger entitles them to let loose. It’s up to other people not to take seriously hurtful things they say or do. After all, they say, they were just angry. They don’t get it that other people are legitimately hurt, embarrassed, humiliated, or afraid.
Helping my patient Richard means helping him identify which of these assumptions are driving his temper tantrums. Some or all may apply. He may even have a few that are more uniquely his own. Teaching him rules for anger management, although important, isn’t enough to have long-term impact. Changing his assumptions will enable him to use such skills with conviction and confidence.

During therapy, the client learns how to identify distorted thinking patterns. The client then learns the connection between distorted thinking and her emotions and behaviors. By making changes to distorted thinking, the client experiences changes in feelings.

Lisa Bonchek Adams died this week after a long and public battle with metastatic breast cancer. Her blog and social media presence offered caring wisdom to so many people affected by cancer. One of her last tweets was “Make the Most of Your Day.” Please take the time to read this article in the New York times about the positive impact she had on the lives of so many.

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Dr. Beck founded the Beck Institute of Cognitive Therapy in 1994. From the Beck Institute website:

Beck Institute for Cognitive Behavior Therapy is a leading international source for training, therapy, and resources in CBT. Our Center for Training delivers workshops to a worldwide audience of mental health professionals, researchers, and educators, and our Philadelphia-based Center for Psychotherapy provides state-of-the-art therapy and consultations.Dr. Aaron T. Beck developed Cognitive Behavior Therapy (CBT) at the University of Pennsylvania in the 1960s. In 1994, Dr. Beck and his daughter, Dr. Judith Beck, established Beck Institute as a non-profit 501(c)(3). Their goal was to create a new clinical setting that would provide both state-of-the-art psychotherapy and comprehensive training opportunities for professionals worldwide.Over the past 20 years, our organization has carried out Dr. Beck’s therapeutic model and guiding principles in training more than 3,500 professionals through our Center for Training, and providing clinical therapy services to over 2,000 individuals, couples, and families through our Center for Psychotherapy.In addition to our professional workshops and on-site psychotherapy practice, Beck Institute remains an international authority on, and resource for, CBT information and research. Our organization continues to partner with universities, hospitals, community mental health centers, health systems, and other institutions to create and improve cognitive behavior therapy programs.